Postoperative pain trajectory and opioid requirements after laparoscopic bariatric surgery: a single-centre historical cohort study.

Purpose: Concerns around delayed emergence and opioid-induced ventilatory impairment in bariatric surgery can lead to intraoperative reliance on short-acting opioids and avoidance of long-acting analgesics with potential sedative effects. Nevertheless, an overly-conservative intraoperative analgesic strategy may result in significant pain at emergence and higher opioid requirements in later phases of care. We sought to establish the pattern of intraoperative analgesic use in bariatric surgical patients as well as their postoperative pain trajectory and opioid requirements.

Predictors of Chronic Pain 6 Months and 1 Year After Bariatric Surgery.

Background: Obesity and chronic pain (CP) represent serious, interrelated global public health concerns that have a profound impact on individuals and society. Bariatric surgery is increasing in popularity and has been proven safe and efficacious, providing long-term weight loss and improvements in many obesity-related co-morbidities. A decrease in CP is often a motivation for bariatric surgery.

E-Survey of Stressors and Protective Factors in Practicing Medical Assistance in Dying.

To better identify, quantify, and understand the current stressors and protective factors reported by Canadian medical assistance in dying (MAiD) assessors and providers to inform policy, education, and supports. E-survey of MAiD stressors ( = 33) and protective factors ( = 27); resilience measurement and comments relating to practice involving physicians and nurse practitioners who provide MAiD services and belong to the Canadian Association of MAiD Assessors and Providers or a francophone equivalent. The survey was conducted, while Parliament was considering changes to MAiD eligibility criteria, which occurred during COVID-19 pandemic restrictions.

What Do Adult Surgical Patients Speaking Primarily Cantonese, Italian, or Portuguese Really Want to Know About Pain and Pain Management?

Background: Surgical patients consider information about pain and pain management to be highly important (Apfelbaum, 2003). At the same time, evidence indicates that members of racial and ethnic minorities are more likely to experience inadequate pain management (Green, Anderson, Baker, Campbell, Decker, Fillingim, & Todd, 2003; Mossey, 2011).

Aims: This study investigated the needs of general day surgery patients who spoke primarily Cantonese, Italian, or Portuguese at home for information about postoperative pain.

A Qualitative Study of Young Adult Experiences in the Bariatric Healthcare System: Psychosocial Challenges and Developmental Difficulties.

Objectives: Bariatric surgery is an evidence-based treatment for severe obesity; however, the unique developmental and psychosocial needs of young adults often complicate care and, as yet, are not well understood. We sought to identify themes in young adult patients undergoing bariatric surgery regarding: 1) the psychosocial experiences of obese young adults (18 to 24) seeking bariatric surgery; 2) the experiences during the preoperative bariatric surgery process and 3) the postoperative experiences of young adult patients.

Methods: In-depth, semistructured individual interviews were conducted with 13 young adult bariatric patients who were seeking or had undergone bariatric surgery within the past 5 years.

Factors Leading to Self-Removal from the Bariatric Surgery Program After Attending the Orientation Session.

Background: Bariatric surgery orientation sessions are often the first point of contact and a recommended component of pre-bariatric surgery assessment. Self-removal rates after bariatric program orientation are as high as 25 % despite the proven efficacy of this procedure. The objective of this study was to identify factors contributing to patient self-removal after orientation using a mixed method approach.

The journey of the pain resource nurse in improving pain management practices: understanding role implementation.

Pain assessment and management continues to be challenging for many nurses. Single educational interventions have proven to be unsuccessful in knowledge retention. This study will assist leaders in nursing in understanding how a 4-day educational program delivered to self-selected pain resource nurses (PRNs) could improve pain assessment and management practices.

Patient-controlled oral analgesia for postoperative pain management following total knee replacement.

Purpose: To investigate whether patient-controlled oral analgesia (PCOA) used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN)-administered oral analgesia.

Methods: Patients who underwent an elective total knee replacement at a quaternary care centre (Toronto Western Hospital, Toronto, Ontario) were randomly assigned to either PCOA or RN-administered short-acting oral opioids on postoperative day 2. Subjects in the RN group called the RN to receive their prescribed short-acting opioid.

What do adult surgical patients really want to know about pain and pain management?

This study investigates the informational content about postoperative pain and pain management that patients identify as being most important. In a descriptive quantitative study design, a convenience sample of 150 general day surgery patients were surveyed by telephone within 72 h after discharge from a hospital day surgery unit. The survey consisted of 19 items rated on a 10-point Likert scale of importance.

Patient-controlled oral analgesia: a low-tech solution in a high-tech world.

The primary concern of surgical patients is the expected experience of pain. Presently, the standard for acute postoperative pain management is intravenous patient-controlled analgesia (PCA). Many authors have reported that patients prefer intravenous PCA to nurse-administered analgesia because it affords them greater control and optimizes their pain relief.